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. 2023 May 11;45(2):182-195.
doi: 10.47626/1516-4446-2022-2876.

Efficacy and safety of ketamine for the treatment of depressive symptoms in palliative care: A systematic review

Matheus Ghossain Barbosa  1 , Gabriela Takayanagi Garcia  2 , Luciana Maria Sarin  1 , Andrea Parolin Jackowski  1
Affiliations

Efficacy and safety of ketamine for the treatment of depressive symptoms in palliative care: A systematic review

Matheus Ghossain Barbosa et al. Braz J Psychiatry. .

Abstract

Objectives: Ketamine has a fast onset of action that may offer a paradigm change for depression management at the end of life. We aimed to synthesize evidence regarding the safety and efficacy of ketamine in depression treatment within a broad palliative care concept.

Methods: We searched seven databases and included studies on the safety and efficacy of ketamine for depression treatment in patients diagnosed with any life-threatening disease. We also conducted a narrative review of the evidence.

Results: Among 2,252 screened titles and abstracts, we included 32 studies in our final synthesis: 14 case reports, two case series, two quasi-experimental studies, and seven randomized clinical trials (RCTs), as well as data from three unpublished clinical trials and seven cases from four larger case series. Most case reports reported a robust effect; however, the larger studies reported conflicting findings. Five RCTs reported positive outcomes; however, four of them were focused on a perioperative setting. Two negative studies did not primarily focus on depression and did not apply severity cutoffs.

Conclusions: Although ketamine is generally safe and potentially useful, its efficacy in palliative care settings remains unclear. It may be a reasonable alternative for perioperative depression in oncological patients.

Keywords: Ketamine; antidepressive agents; depression; mood disorders; palliative care.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.
See this image and copyright information in PMC

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